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Zong Z, Zhang Y, Qiao J, Tian Y, Xu S. The association between screen time exposure and myopia in children and adolescents: a meta-analysis. BMC Public Health 2024; 24:1625. [PMID: 38890613 PMCID: PMC11186094 DOI: 10.1186/s12889-024-19113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature. METHOD There were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period. RESULTS We searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47-3.42) for cross-sectional studies, and 2.39 (2.07-2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01-1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78-14.04; continuous: OR = 1.22, 95%CI: 1.10-1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02-2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method. CONCLUSION Our findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.
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Affiliation(s)
- Zhiqiang Zong
- The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yaxin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Jianchao Qiao
- The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yuan Tian
- The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Shaojun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
- MOE Key Laboratory of Population Health Across Life Cycle, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Garg A, Rathnam U, Gupta V, Grover S, Manna S. Student Satisfaction and Physical Health Effects of Online Learning Among Medical and Paramedical Undergraduates in Northern India: A Cross-Sectional Study. Cureus 2024; 16:e62137. [PMID: 38993464 PMCID: PMC11238260 DOI: 10.7759/cureus.62137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Online modality of pedagogy was introduced in many medical institutes globally, especially during the COVID-19 pandemic. However, these techniques were not evaluated, either with respect to effectiveness or student satisfaction in terms of promoting successful educational outcomes. The current study was conducted to identify determinants of student satisfaction with respect to online learning, in the post-pandemic era. METHODS A pilot-tested and validated online questionnaire was administered to 370 medical/paramedical students who attended online classes during the pandemic. The students were selected randomly from four different streams of a medical university, representing all the years of study. The questionnaire included Likert-type questions and was divided into two parts: socio-demographic profile and satisfaction with online learning. RESULTS The response rate was 81.4%. Overall satisfaction with online learning among students was 35.9% and the areas of most satisfaction for students were user-friendliness of the online portal (65.5%), self-directed responsibilities assigned to pupils (49.9%), faculty accessibility/availability (48.8%) and timely evaluation, test and feedback (47.9%). The areas of most dissatisfaction were lack of personal effect as compared to offline learning (n=71, 23.6%), effect on social life (n=54, 17.9%), and feeling of not belonging to the online session (n=38, 12.6%). Multiple regression analysis demonstrated that having previous exposure to online courses and having a separate room led to more satisfaction, whereas the emergence of health problems led to poor satisfaction with the course. The duration of previous exposure to online courses was not a statistically significant predictor of satisfaction. One or more health problems were reported by 176 (58.5%) of the respondents. Some of the common health problems reported were eye strain (72.8%), headache (56.1%), insomnia (47.2%), stress (35.2%), muscle fatigue (22.6) and tingling sensation (10.6%). CONCLUSION Adopting a combination of online and offline approaches, i.e., blended pedagogy, involving different methods to involve students and their feedback are important to ensure student satisfaction.
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Affiliation(s)
- Aseem Garg
- Internal Medicine, Kalpana Chawla Government Medical College, Karnal, IND
| | - Usharani Rathnam
- General Surgery, Employees State Insurance Corporation Medical College and Hospital, Alwar, IND
| | - Varsha Gupta
- Community Medicine, Government Medical College, Alwar, IND
| | - Sumit Grover
- Ophthalmology, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Souvik Manna
- Community Medicine, Employees State Insurance Corporation Medical College and Hospital, Alwar, IND
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Al Hassan S, Bou Ghannam A, S Saade J. An Emerging Ophthalmology Challenge: A Narrative Review of TikTok Trends Impacting Eye Health Among Children and Adolescents. Ophthalmol Ther 2024; 13:895-902. [PMID: 38315349 PMCID: PMC10912387 DOI: 10.1007/s40123-024-00885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
In today's digital age, children and teenagers are deeply entrenched in the world of personal electronic devices including laptops, tablets, and smartphones. These serve as gateways to captivate online content. With children as young as 4 years old having access to these gadgets, the potential benefits of technology coexist with many possible risks. One such risk is the growing global issue of myopia. TikTok, a mobile application that gained immense popularity since its inception in 2016, has garnered 1.7 billion active monthly users in 2023 and is expected to reach two billion in 2024. A significant portion of TikTok's user base consists of adolescents, with approximately 41% falling in the 16-24 age group and a third aged 14 or younger. This social media platform has given rise to the phenomenon of "internet challenges," where users complete and share various tasks through videos. While most of these challenges are harmless, some pose serious risks to teenagers who eagerly seek validation and attention from their peers. This manuscript sheds light on a specific subset of TikTok challenges, namely those related to ophthalmological risks. These challenges include "rubbing castor oil trend," "bleach/bright eye challenge," "mucus fishing challenge," "eggsplosions", "beezin challenge", "Orbeez challenge", "blow-drying eyelashes", "sun gazing," and "popping styes". The manuscript emphasizes the importance of monitoring and regulating potentially dangerous content on social media platforms like TikTok. While these platforms offer educational opportunities, they can also promote life-threatening actions, necessitating efforts to protect vulnerable young users and promote safe online engagement.
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Affiliation(s)
- Sally Al Hassan
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alaa Bou Ghannam
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joanna S Saade
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
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Zhu H, Liu C, Gao M, Zhang S, Zhang L, Zhao Q. Choroidal thickness in relation to diopter and axial length among myopic children. Front Med (Lausanne) 2023; 10:1241352. [PMID: 37928462 PMCID: PMC10623004 DOI: 10.3389/fmed.2023.1241352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The aim of this study was to analyze the relationship between diopter (D) and choroidal thickness in myopic children by describing the values of choroidal thickness, and explore choroidal thickness as an important indicator for evaluating the progression of myopia. Methods The study included myopic and emmetropic children aged 6-14 years (156 eyes) from the Second Hospital of Dalian Medical University. The participants were divided into four groups according to the spherical equivalent refraction (SER): low myopes, moderate myopes, high myopes, and emmetropes. Choroidal thickness was measured in nine areas using the Early Treatment Diabetic Retinopathy Study (ETDRS) grid layout, which divided the areas into concentric circles of 0 × 0 mm, 3 × 3 mm, and 5 × 5 mm from the Sub Fovea. The images were obtained manually with spectral-domain optical coherence tomography scanner. Results There were significant differences of choroidal thickness in the nine areas of the ETDRS grid for all myopes. The distribution of choroidal thickness in low and moderate myopes were different from that in high myopes. In the horizontal direction, choroidal thickness decreased from the temporal to nasal areas for all myopes. In the vertical direction, the choroidal thickness in the perifovea was smaller than that in the parafovea (SER ≥ -2.75D), and the choroidal thickness in the perifovea was greater than that in the parafovea (SER < -2.75D). When comparing emmetropes with myopes, the closer the choroidal thickness was to the central fovea, the more significant the differences were, while the differences were smaller to the perifovea. Among all children, choroidal thickness was positive to SER and negative to axial length (AL) in all areas. For every 1D increase in myopia, the subfoveal choroidal thickness decreased by 13 μm, and for every 1 mm increase in AL, the subfoveal choroidal thickness decreased by 23 μm. Furthermore, SER and AL showed the strongest correlation with choroidal thickness in the inferior area. Conclusion Optical coherence tomography results revealed choroidal thickness was thinner in myopic children. Choroidal thickness was positive to SER and negative to AL. Therefore, we consider choroidal thickness to be an important indicator for evaluating the myopia progress.
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Affiliation(s)
| | | | | | | | | | - Qi Zhao
- Department of Ophthalmology, The Second Hospital of Dalian Medical University, Dalian, China
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Long H, Shi MH, Li X. Efficacy and safety of atropine in myopic children: A meta-analysis of randomized controlled trials. J Fr Ophtalmol 2023; 46:929-940. [PMID: 37147148 DOI: 10.1016/j.jfo.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE To evaluate the safety and efficacy of atropine for childhood myopia and further explore the optimal concentration of atropine, so as to provide more reference for clinical application. METHODS PubMed, Embase, Cochrane Library and ClinicalTrials.gov were comprehensively searched for randomized controlled trials (RCTs) up to October 14, 2021. The efficacy outcomes were progression of spherical equivalent (SE) and axial length (AL). The safety outcomes included accommodation amplitude, pupil size and adverse effects. The meta-analysis was performed using Review Manager 5.3. RESULTS Eighteen RCTs involving 3002 eyes were included. The results showed that at 6-36 months of treatment, atropine was effective in slowing the progression of myopia in children. At 12 months, the WMD of SE and AL of low-dose atropine was 0.25 diopters (D) and 0.1 millimeter (mm), moderate-dose atropine was 0.44 D and 0.16mm, high-dose atropine was 1.21 D and 0.82mm, respectively, compared with the control group. Similarly, at 24 months, low-dose atropine was 0.22 D and 0.14mm, moderate-dose atropine was 0.60 D, high-dose atropine was 0.66 D and 0.24mm, respectively. Interestingly, we also found that there was no significant difference in the effects of low-dose atropine on accommodation amplitude and photopic pupil size compared with the control group, and the rate of photophobia, allergy, blurred vision and other side effects was similar between the low-dose atropine group and the control group. In addition, atropine appears to be more effective in myopic children in China than in other countries. CONCLUSIONS Atropine in various concentrations can effectively slow myopia progression in children, and its effect is dose-dependent, while low-dose atropine (0.01% atropine) appears to be safer.
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Affiliation(s)
- H Long
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - M H Shi
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - X Li
- Aier Eye Hospital of Wuhan University, Wuhan, China.
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Champagne-Hamel M, Monfort C, Chevrier C, Saint-Amour D. Screen Time at 6 Years Old and Visual Function in Early Adolescence. Vision (Basel) 2023; 7:63. [PMID: 37873891 PMCID: PMC10594439 DOI: 10.3390/vision7040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
Excessive screen time has been linked to adverse health outcomes in children, including vision-related problems such as myopia. However, very few studies have evaluated the effect of moderate screen exposure on the development of visual functions. This study aimed to examine the association between screen time during middle childhood and color discrimination, contrast sensitivity, and short-range visual acuity in 12-year-old children (n = 305) from the mother-child PELAGIE cohort (France) for the whole sample and for boys and girls separately. Visual functions were assessed using the Freiburg Acuity and Contrast Test and an adapted version of the Cambridge Color Test. Screen exposure was documented using a parent self-report questionnaire. Regression models showed that screen exposure at 6 years of age was significantly associated with higher contrast sensitivity across the entire sample at 12 years of age. However, when controlling for covariates, this association remained statistically significant in girls only. Sex-stratified analyses also showed that moderate screen exposure was linked to improved tritan-axis color vision in boys only. These findings suggest that moderate screen exposure in middle childhood is not harmful to visual function development and as such, provide new insights into the impact of digital technology on children's visual health and development.
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Affiliation(s)
| | - Christine Monfort
- Inserm, EHESP, Irset—UMR_S 1085, Université Rennes, F-35000 Rennes, France; (C.M.); (C.C.)
| | - Cécile Chevrier
- Inserm, EHESP, Irset—UMR_S 1085, Université Rennes, F-35000 Rennes, France; (C.M.); (C.C.)
| | - Dave Saint-Amour
- Department of Psychology, Université du Québec à Montréal, Montreal, QC H2V 2S9, Canada;
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC H3C 3J7, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC H3C 3J7, Canada
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March de Ribot F, Salgado-Borges J, Benitez Del Castillo J. Visual complaints during the COVID-19 pandemic in Spain and Portugal. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00070-1. [PMID: 37178785 PMCID: PMC10174337 DOI: 10.1016/j.oftale.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/09/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE This study reports visual health during the COVID-19 pandemic in 2021 in Spain and Portugal, focusing on eye complaints and population habits. MATERIAL AND METHODS Cross-sectional survey through an online email invitation to patients attending ophthalmology clinics in Spain and Portugal from September to November 2021. Around 3833 participants offered valid anonymous responses in a questionnaire. RESULTS Sixty percent of respondents identified significant discomfort related to dry eye symptoms for increased screen time and lens fogging using facemasks. 81.6% of the participants used digital devices for more than 3 h per day and 40% for more than 8 h. In addition, 44% of participants referred to worsening near vision. The most frequent ametropias were myopia (40.2%) and astigmatism (36.7%). Parents considered eyesight the most important aspect of their children (87.2%). CONCLUSIONS The results show the challenges for eye practices during the initial COVID-19 pandemic. Focusing on signs and symptoms that lead to ophthalmologic conditions is an essential concern, especially in our digital society highly dependent on vision. At the same time, the excessive use of digital devices during this pandemic has aggravated dry eye and myopia.
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Affiliation(s)
- F March de Ribot
- Departamento de Oftalmología, Hospital Universitario de Girona, Girona, Spain.
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Shah R, Edgar DF, Evans BJW. Worsening vision at age 4-5 in England post-COVID: Evidence from a large database of vision screening data. Ophthalmic Physiol Opt 2023; 43:454-465. [PMID: 36866712 DOI: 10.1111/opo.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE Myopia prevalence has increased in the UK at age 10-16y, but little is known about younger children. We hypothesise that if the 'myopia epidemic' is affecting young children, then there will be increasing rates of bilateral reduced unaided vision (V) at vision screenings of children 4-5 years of age. METHODS Retrospective anonymised data from computerised vision screening at age 4-5 years were analysed from serial cross-sectional data. Refractive error is not assessed in UK vision screening, so vision was investigated. Data were only included from schools that screened every year from 2015/16 to 2021/22. The criterion used was unaided monocular logMAR (automated letter-by-letter scoring) vision >0.20 in both the right and left eyes, so as to maximise the chances of detecting bilateral, moderate myopia rather than amblyopia. RESULTS Anonymised raw data were obtained for 359,634 screening episodes from 2075 schools. Once schools were excluded where data were not available for every year and data were cleaned, the final database comprised 110,076 episodes. The proportion (percentage and 95% CI) failing the criterion from 2015/16 to 2021/22 were 7.6 (7.2-8.0), 8.5 (8.1-8.9), 7.5 (7.1-7.9), 7.8 (7.4-8.2), 8.7 (8.1-9.2), 8.5 (7.9-9.0) and 9.3 (8.8-9.7), respectively. The slope of the regression line showed a trend for increasing rates of reduced bilateral unaided vision, consistent with increasing frequency of myopia (p = 0.06). A decreasing linear trendline was noted for children 'Under Professional Care'. CONCLUSIONS For children 4-5 years of age, there were signs of reduced vision over the last 7 years in England. Consideration of the most likely causes support the hypothesis of increasing myopia. The increase in screening failures highlights the importance of eye care in this young population.
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Affiliation(s)
- Rakhee Shah
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
| | - David F Edgar
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
| | - Bruce J W Evans
- Institute of Optometry, London, UK.,Centre for Applied Vision Research, City, University of London, London, UK
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Dutheil F, Oueslati T, Delamarre L, Castanon J, Maurin C, Chiambaretta F, Baker JS, Ugbolue UC, Zak M, Lakbar I, Pereira B, Navel V. Myopia and Near Work: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:875. [PMID: 36613196 PMCID: PMC9820324 DOI: 10.3390/ijerph20010875] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Myopia is a global public health problem affecting quality of life and work productivity. Data is scarce regarding the effects of near work on myopia. Providing a larger meta-analysis with life-long perspective, including adults and occupational exposure seemed needed. METHODS We searched PubMed, Cochrane Library, Embase and Science Direct for studies reporting myopia prevalence in near work. Myopia was defined as a mean spherical equivalent ≤ -0.50 diopter. We performed a meta-analysis using random-effects model on myopia prevalence, myopia progression per year, and odds ratio (OR) of myopia in near work, completed by subgroup analyses and meta-regressions on patients' characteristics, type of work in adults, geographic zones, time and characteristics of near work. RESULTS We included 78 studies, representing a total of 254,037 participants, aged from 6 to 39 years. The global prevalence of myopia in near work was 35% (95% CI: 30 to 41%), with a prevalence of 31% (95% CI: 26 to 37%) in children and 46% (95% CI: 30 to 62%) in adults. Myopia progression was -0.39 diopters per year (-0.53 to -0.24 D/year), ranging from -0.44 (-0.57 to -0.31) in children to -0.25 D/year (-0.56 to 0.06) in adults. The odds of myopia in workers exposed vs. non-exposed to near work were increased by 26% (18 to 34%), by 31% (21 to 42%) in children and 21% (6 to 35%) in adults. Prevalence of myopia was higher in adults compared to children (Coefficient 0.15, 95% CI: 0.03 to 0.27). CONCLUSIONS Near work conditions, including occupational exposure in adults, could be associated with myopia. Targeted prevention should be implemented in the workplace.
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Affiliation(s)
- Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Physiological and Psychosocial Stress, CNRS, LaPSCo, Université Clermont Auvergne, WittyFit, 63001 Clermont-Ferrand, France
| | - Tharwa Oueslati
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Louis Delamarre
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Physiological and Psychosocial Stress, CNRS, LaPSCo, Université Clermont Auvergne, WittyFit, 63001 Clermont-Ferrand, France
- Department of Anesthesiology and Intensive Care, University Hospital of Marseille, Hopital Nord—Assistance Publique Hôpitaux de Marseille, 13015 Marseille, France
| | - Joris Castanon
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Caroline Maurin
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Frédéric Chiambaretta
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Physical Education and Health, Kowloon Tong, Hong Kong Baptist University, Hong Kong
| | - Ukadike C. Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Marek Zak
- Faculty of Medicine and Health Sciences, Institute of Physiotherapy, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Ines Lakbar
- Department of Anesthesiology and Intensive Care, University Hospital of Marseille, Hopital Nord—Assistance Publique Hôpitaux de Marseille, 13015 Marseille, France
| | - Bruno Pereira
- Biostatitics, Clinical Research Direction, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Valentin Navel
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
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Kanclerz P, Lanca C, Radomski SA, Nowak MS. The outdoor time in non-myopic children has decreased to that of myopic children during the SARS-CoV-2 pandemic. Rom J Ophthalmol 2023; 67:33-40. [PMID: 37089804 PMCID: PMC10117183 DOI: 10.22336/rjo.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 04/25/2023] Open
Abstract
Objective: Low levels of outdoor activity are known to be an important risk factor for the development of myopia in schoolchildren. This study aimed to determine outdoor and near work patterns in Polish schoolchildren before and during school closure due to the SARS-CoV-2 pandemic. Methods: All children undergoing a routine pediatric examination in the Elbląg branch of the Hygeia Clinic, together with their parents, were asked to fill an anonymous questionnaire. The subject's age, spherical equivalent (SE) refractive error, time spent outdoors, screen time and total near work in hours per day before and during the pandemic, were recorded. As substantial differences in physical activity by time of year were reported, activity patterns for June (summer) and December (winter) were recorded. Multiple logistic regression analysis was used to analyze the association between the presence of myopia and outdoor and total near work time at different timepoints. Results: A total of 61 schoolchildren aged 11.95 ± 2.74 (range 7 to 17) years were included in this study. The mean SE in the right eye was -1.78 ± 2.11 with 46% of the individuals (n=28) classified as myopic. Before the pandemic, higher time outdoors was associated with less myopic SE (OR=0.47, 95% Confidence Interval [CI] 0.24 to 0.93). During the pandemic, time outdoors among non-myopic children was similar to myopic children, both during winter and summer months (2.18 ± 1.81 vs. 1.89 ± 1.50; P=.51, and 3.47 ± 2.66 vs. 3.31 ± 1.65; P=.79 respectively). Time outdoors was not significantly associated with myopia during the pandemic (OR=1.17, 95% CI 0.64 to 2.14). Total near work was not associated with myopia at any time point. Conclusion: The long-term influence of the changing patterns of outdoor and near work on myopia prevalence and progression in our population is still to be established. Nevertheless, it is likely that the decrease of outdoor time may influence the rates of myopia in this region.
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Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdansk, Poland
- Helsinki Retina Research Group, University of Helsinki, Finland
| | - Carla Lanca
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Michał Szymon Nowak
- Institute of Optics and Optometry, University of Social Sciences Lodz, Poland
- Provisus Eye Clinic, Częstochowa, Poland
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Pan W, Lin J, Zheng L, Lan W, Ying G, Yang Z, Li X. Myopia and axial length in school-aged children before, during, and after the COVID-19 lockdown-A population-based study. Front Public Health 2022; 10:992784. [PMID: 36589986 PMCID: PMC9799254 DOI: 10.3389/fpubh.2022.992784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Myopic shift had been observed during the COVID-19 lockdown in young school children. It remains unknown whether myopic shift is accompanied with increase in axial length. We aimed to evaluate the impact of the COVID-19 lockdown on myopia and axial length of school children in China by comparing them before, during and after the lockdown. Methods In this population-based cross-sectional study, school-based myopia screenings were conducted in the Fall of 2019, 2020, and 2021 (representing before, during and after COVID-19 lockdown respectively) in Chengdu, China. Myopia screenings were performed on 83,132 students aged 6 to 12 years. Non-cycloplegic refractive error was examined using NIDEK auto-refractor (ARK-510A; NIDEK Corp., Tokyo, Japan) and axial length was measured using AL-Scan (NIDEK Corp., Tokyo, Japan). Spherical equivalent (SER, calculated as sphere+ 0.5*cylinder), prevalence of myopia (SER ≤ -0.50 D), and axial length were compared across 3 years stratified by age. Results Myopia prevalence rate was 45.0% (95% CI: 44.6-45.5%) in 2019, 48.7% (95% CI: 48.3-49.1%) in 2020, and 47.5% (95% CI: 47.1-47.9%) in 2021 (p < 0.001). The mean non-cycloplegic SER (SD) was -0.70 (1.39) D, -0.78 (1.44) D, and -0.78 (1.47) D respectively (p < 0.001). The mean (SD) axial length was 23.41 (1.01) mm, 23.45 (1.03) mm, and 23.46 (1.03) mm across 3 years respectively (p < 0.001). From the multivariable models, the risk ratio (RR) of myopia was 1.07 (95% CI: 1.06-1.08) times, the SER was 0.05 D (95% CI: 0.04 D to 0.06 D) more myopic and the mean axial length increased by 0.01 mm (95% CI: 0.01 mm to 0.02 mm) in 2020 compared to 2019. In 2021, the risk ratio (RR) of myopia was 1.05 (95% CI: 1.04-1.06), the mean SER was 0.06 D (95% CI: 0.05 D to 0.07 D) more myopic, and the mean axial length increased by 0.03 mm (95% CI: 0.02 mm to 0.04 mm) compared to 2019. Conclusions The COVID-19 lockdown had significant impact on myopia development and axial length, and these impacts remained 1 year after the lockdown. Further longitudinal studies following-up with these students are needed to help understand the long-term effects of COVID-19 lockdown on myopia.
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Affiliation(s)
- Wei Pan
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
| | - Jiang Lin
- Chengdu Aier Eye Hospital, Chengdu, China
| | - Li Zheng
- Education Bureau of Qingyang District, Chengdu, China
| | - Weizhong Lan
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China,Aier School of Ophthalmology, Central South University, Changsha, China,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Guishuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhikuan Yang
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China,Aier School of Ophthalmology, Central South University, Changsha, China,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China
| | - Xiaoning Li
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China,Changsha Aier Eye Hospital, Changsha, China,Hunan Province Optometry Engineering and Technology Research Center, Changsha, China,Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China,*Correspondence: Xiaoning Li
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12
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Dong Y, Jan C, Chen L, Ma T, Liu J, Zhang Y, Ma Q, Zhong P, Song Y, Ma J, Patton GC, Sawyer SM. The Cumulative Effect of Multilevel Factors on Myopia Prevalence, Incidence, and Progression Among Children and Adolescents in China During the COVID-19 Pandemic. Transl Vis Sci Technol 2022; 11:9. [PMID: 36515964 DOI: 10.1167/tvst.11.12.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To estimate the effects of school closures and associated lifestyle changes on myopia in Chinese children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods Two cross-sectional surveys recruited 14,296 Chinese students aged 7 to 18 years in November 2019 and June 2020 from which an open cohort study (nested queue design) was derived and used to assess myopia prevalence, incidence, and progression rates (defined as students with progression in myopia severity at the second survey wave among those with myopia at baseline). The severity of myopia was determined by measurements of visual acuity (<5.0) and noncycloplegic refraction (spherical equivalent <-0.50 diopters). Twenty-three myopia-influencing factors were divided into three categories: eye-use habits, lifestyle, and family and subjective factors. Responses to each of these 23 factors were labeled as either positive or negative options and then combined to generate a comprehensive score. Results Boys and girls were equally represented (50%) and had the same average age (11.5 years) at each wave. The myopia prevalence increased from 48.2% to 60.0%, with 27.1% myopia incidence and 13.2% myopia progression rates for Chinese children and adolescents. Each of the 23 factors was associated with myopia prevalence but had no significant effect on myopia incidence or progression. However, these 23 factors had a cumulative effect on myopia risks; higher scores were associated with more positive factors and lower risk ratios of myopia and vice versa. Except for the progression rate, the myopia prevalence and incidence and risk ratios decreased with higher comprehensive scores. Conclusions School closures during the COVID-19 pandemic increased the risk of myopia in Chinese children and adolescents due to the accumulation of poor eyesight habits, unhealthy lifestyles, and excessive screen time. Translational Relevance Rather than focusing on single risk factors for myopia, future myopia prevention strategies should focus on integrating multiple comprehensive approaches across schools, families, and communities.
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Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Catherine Jan
- Centre for Eye Research Australia, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, Australia.,School of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Lost Child's Vision Project, Sydney, New South Wales, Australia
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - George C Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
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13
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Wang W, Xiang Y, Zhu L, Zheng S, Ji Y, Lv B, Xiong L, Li Z, Yi S, Huang H, Zhang L, Liu F, Zhang T, Wan W, Hu K. Myopia progression and associated factors of refractive status in children and adolescents in Tibet and Chongqing during the COVID-19 pandemic. Front Public Health 2022; 10:993728. [PMID: 36324441 PMCID: PMC9619363 DOI: 10.3389/fpubh.2022.993728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives To investigate myopia progression and associated factors of refractive status among children and adolescents in Tibet and Chongqing in China during the COVID-19 pandemic. Methods A population-based cross-sectional study was conducted to compare rates of myopia and high myopia, axial length (AL), spherical equivalent (SE), outdoor activity time, digital device use, and frequency of visual examinations for children and adolescents affected by myopia in Chongqing and Tibet in 2021. Results A total of 2,303 students from Chongqing and 1,687 students from Tibet were examined. The overall prevalence of myopia and high myopia in these two groups were 53.80 and 7.04% vs. 43.86 and 1.30%, respectively in each case. The Chongqing students had a longer AL than the group from Tibet (23.95 vs. 23.40 mm, respectively; p < 0.001). The mean SE of the students with myopic parents in Tibet was lower than that of the students in Chongqing with myopic parents (-2.57 ± 2.38 diopters (D) vs. -2.30 ± 2.34 D, respectively) (p < 0.001). Conversely, the mean SE of the students from urban areas in Chongqing was lower than that of the students in Tibet (-2.26 ± 2.25 D vs. -1.75 ± 1.96 D, respectively; p < 0.001). The Chongqing students exhibited lower SE (-2.44 ± 2.22 D) than their Tibetan counterparts (mean SE: -1.78 ± 1.65 D (p = 0.0001) when spending more than 2.5 h outdoors. For example, 61.35% of the students in Tibet spent more than 2.5 h outdoors daily, compared with 43.04% of the students in Chongqing. Correspondingly, the proportion of students using digital devices in Tibet (64.43%) was lower than that in Chongqing (100%). For the latter, 38.62% of the students in Chongqing spent more than 2.5 h online using digital devices compared to 10.49% of the students in Tibet. Greater monitoring of visual status was observed for the Chongqing students (mean SE: -1.90 ± 1.98 D) compared with students in Tibet (mean SE: -2.68 ± 1.85 D) (p = 0.0448), with the frequency of optimal examinations being every 6 months. Outdoor activity time was identified as a common risk factor for myopia in both of the populations examined, with odds ratios (ORs) of 1.84 (95% CI: 1.79-1.90) in Chongqing and 0.84 (95% CI: 0.73-0.96) in Tibet. Digital screen time was associated with myopia and high myopia in Chongqing, with ORs of 1.15 (95% CI: 1.08-1.22) and 1.06 (95% CI: 0.94-1.77), respectively. Digital screen time was also found to be a risk factor for high myopia in Tibet (OR: 1.21, 95% CI: 0.77-1.61). The type of digital devices used was also associated with myopia and high myopia in Tibet (OR: 1.33, 95% CI: 1.06-1.68 and OR: 1.49, 95% CI: 0.84-2.58, respectively). Finally, examination frequency was found to correlate with high myopia in the Tibet group (OR: 1.79, 95% CI: 0.66-2.71). Conclusion Based on our data, we observed that the prevalence of refractive errors in children and adolescents was significantly lower in Tibet than in Chongqing. These results are potentially due to prolonged outdoor activity time, and the type and time of use for digital devices that characterize the group of children and adolescents from Tibet. It is recommended that parents and children in Chongqing would benefit from increased awareness regarding myopia progression and its prevention.
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Affiliation(s)
- Wujiao Wang
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongguo Xiang
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lu Zhu
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shijie Zheng
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Ji
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bingjing Lv
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Xiong
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhouyu Li
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shenglan Yi
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyun Huang
- Department of Sports, Health and Arts, Chongqing Municipal Education Commission, Chongqing, China
| | - Li Zhang
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fangli Liu
- Education Department, Physical, Health and Art Education Research Center, National Institute of Education Sciences, Beijing, China
| | - Tong Zhang
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Wenjuan Wan
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Wenjuan Wan
| | - Ke Hu
- Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,The First Clinical College, Chongqing Medical University, Chongqing, China,Ke Hu
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López-Ruiz VR, Alfaro-Navarro JL, Huete-Alcocer N, Nevado-Peña D. Psychological and Social Vulnerability in Spaniards' Quality of Life in the Face of COVID-19: Age and Gender Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610269. [PMID: 36011905 PMCID: PMC9408594 DOI: 10.3390/ijerph191610269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 05/30/2023]
Abstract
Following the serious health situation in Spain and around the world in 2020 and 2021 stemming from COVID-19, this paper examines how the most vulnerable groups (in social and health terms) in Spanish society suffered the worst impacts on their quality of life during the pandemic. The review of the literature and publications released by the health authorities highlight the high number of cases of illness and death due to COVID-19; however, there are no studies about how it has affected aspects of citizens' daily lives, considering some of their sociodemographic characteristics such as age and gender. A key issue when measuring citizens' quality of life is that we typically see a U-shaped curve by age group, where young people register the highest shares along with the elderly; nevertheless, the pandemic has clearly brought about a change in this regard. In this study, we corroborate this finding, along with the psychological issues underlying this fact in young people and the physical ones in the elderly. To do so, we use an ANOVA and regression analysis with data from a sample of 908 Spanish citizens belonging to different age groups. These data were collected through an online survey distributed throughout Spain, mostly by email and social media, between 15 February and 15 April 2021 with a margin of error of 3.25% and a confidence level of 95%. Furthermore, the analysis allowed us to determine how aspects of daily life-family situation, living conditions, social environment, employment and financial situation-have been negatively affected during the pandemic, clearly depending on the age of the people surveyed, pushing them towards social and health vulnerability.
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Affiliation(s)
- Víctor-Raúl López-Ruiz
- Department of Spanish and International Economics, Econometrics and History and Economic Institutions, University of Castilla-La Mancha, 02071 Albacete, Spain
| | - José Luis Alfaro-Navarro
- Department of Political Economy and Public Finance, Economic and Business Statistics and Economic Policy, University of Castilla-La Mancha, 02071 Albacete, Spain
| | - Nuria Huete-Alcocer
- Department of Spanish and International Economics, Econometrics and History and Economic Institutions, University of Castilla-La Mancha, 02071 Albacete, Spain
| | - Domingo Nevado-Peña
- Department Business Administration, University of Castilla-La Mancha, 13071 Albacete, Spain
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15
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Yien L, Lun K, Ngo C. Let Us Avoid a ‘Myopic View’ in Times of COVID-19. CHILDREN 2022; 9:children9081125. [PMID: 36010016 PMCID: PMC9406293 DOI: 10.3390/children9081125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic has affected people from almost all facets of life and it’s impact is extremely palpable among students. In this review paper, we discuss about the risk factors for myopia progression that were exacerbated by the pandemic, which are supported by evidence from studies published recently. It is imperative that measures are put in place to address the rising incidence of myopia so as to prevent the impending myopia pandemic.
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Kaur K, Gurnani B, Nayak S, Deori N, Kaur S, Jethani J, Singh D, Agarkar S, Hussaindeen JR, Sukhija J, Mishra D. Digital Eye Strain- A Comprehensive Review. Ophthalmol Ther 2022; 11:1655-1680. [PMID: 35809192 PMCID: PMC9434525 DOI: 10.1007/s40123-022-00540-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/14/2022] [Indexed: 11/02/2022] Open
Abstract
Digital eye strain (DES) is an entity encompassing visual and ocular symptoms arising due to the prolonged use of digital electronic devices. It is characterized by dry eyes, itching, foreign body sensation, watering, blurring of vision, and headache. Non-ocular symptoms associated with eye strain include stiff neck, general fatigue, headache, and backache. A variable prevalence ranging from 5 to 65% has been reported in the pre-COVID-19 era. With lockdown restrictions during the pandemic, outdoor activities were restricted for all age groups, and digital learning became the norm for almost 2 years. While the DES prevalence amongst children alone rose to 50-60%, the symptoms expanded to include recent onset esotropia and vergence abnormalities as part of the DES spectrum. New-onset myopia and increased progression of existing myopia became one of the most significant ocular health complications. Management options for DES include following correct ergonomics like reducing average daily screen time, frequent blinking, improving lighting, minimizing glare, taking regular breaks from the screen, changing focus to distance object intermittently, and following the 20-20-20 rule to reduce eye strain. Innovations in this field include high-resolution screens, inbuilt antireflective coating, matte-finished glass, edge-to-edge displays, and image smoothening graphic effects. Further explorations should focus on recommendations for digital screen optimization, novel spectacle lens technologies, and inbuilt filters to optimize visual comfort. A paradigm shift is required in our understanding of looking at DES from an etiological perspective, so that customized solutions can be explored accordingly. The aim of this review article is to understand the pathophysiology of varied manifestations, predisposing risk factors, varied management options, along with changing patterns of DES prevalence post COVID-19.
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Affiliation(s)
- Kirandeep Kaur
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007, India.
| | - Bharat Gurnani
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007, India
| | - Swatishree Nayak
- Department of Ophthalmology, AIIMS, Raipur, Chhattisgarh, 492001, India
| | | | - Savleen Kaur
- Advanced Eye Center, Post Graduate Institute of Ophthalmology, Chandigarh, 160012, India
| | - Jitendra Jethani
- Baroda Children Eye Care and Squint Clinic, Vadodara, Gujarat, 390007, India
| | | | - Sumita Agarkar
- Department of Pediatric Ophthalmology and Adult Strabismus, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, 600006, India
| | | | - Jaspreet Sukhija
- Advanced Eye Center, Post Graduate Institute of Ophthalmology, Chandigarh, 160012, India
| | - Deepak Mishra
- Department of Ophthalmology, Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
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Trovato Battagliola E, Mangiantini P, D’Andrea M, Malvasi M, Loffredo L, Scalinci SZ, Comberiati AM, Migliorini R, Pacella E. Effect of COVID-19 lockdown on refractive errors in Italian children aged 5-12 years: A multi-center retrospective study. Eur J Ophthalmol 2022; 33:112-122. [PMID: 35678641 PMCID: PMC9189327 DOI: 10.1177/11206721221106135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE to explore the potential consequences of the COVID-19 lockdown on the prevalence of myopia among Italian children aged 5-12 years. MATERIALS AND METHODS retrospective multicenter study conducted in Italy. Population: children aged 5-12. Selection: random selection of children who received an eye exam between 2016 to 2021. Inclusion criteria: healthy children presenting for a routine eye exam. Exclusion criteria: presence of ocular comorbidities other than refractive error, such as blepharoptosis, media opacities, corneal or retinal dystrophies, strabismus, amblyopia, or concurrent therapy with atropine 0.01%. Outcome measure: age and spherical equivalent (SE) measured in diopters (D) in the right eye (RE) in cycloplegia. Statistical analysis: ANOVA test. RESULTS total of 803 children. In the years prior to COVID-19, the mean SE ± SD of healthy age-school children was: 0.54 ± 1.49 D in 2016; 0.43 ± 1.84 D in 2017; 0.34 ± 1.41 D in 2018; 0.35 ± 1.75 D in 2019 (ANOVA, p = .659). In 2021, the mean SE changed to -0.08 ± 1.44 D (ANOVA, p = .005). Mean age was comparable in all groups (ANOVA, p = .307). The prevalence of myopes (SE ≤-0.5D) and hyperopes (SE ≥ 2D) was respectively 24.10% and 9.64% among children aged 60-96 months, and 63.86% and 6.02% among children aged 97-144 months. These values represent a statistically-significant increase in the number of myopes (Chi-square, p = .016) and decrease in the number of hyperopes (Chi-square, p = .001), as compared to previous years (.06 and.48 respectively). CONCLUSION this retrospective study shows a statistically-significant decrease in the mean SE in children aged 5-12 in the year following the COVID-19 lockdown. The percentage of myopes has increased significantly, while the percentage of hyperopes has decreased. The lifestyle changes caused by the lockdown led children to spend more time on near-work activities and digital devices, and less time outdoors. These are known risk factors for the development and progression of myopia. Studies in different countries are encouraged.
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Affiliation(s)
| | - Pietro Mangiantini
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Mattia D’Andrea
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Mariaelena Malvasi
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | - Anna Maria Comberiati
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Raffaele Migliorini
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy,Elena Pacella, Department of Sense Organs, University Sapienza, Rome, Policlinico Umberto I, Viale, del Policlinico 155 - 00161 Rome, Italy.
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Trott M, Driscoll R, Irlado E, Pardhan S. Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine 2022; 48:101452. [PMID: 35615691 PMCID: PMC9122783 DOI: 10.1016/j.eclinm.2022.101452] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Screen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic. METHODS A systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time. FINDINGS After review, 89 studies (n = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6-10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1-1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7-1·2), adolescents (11-17 years; 0·9 hrs/day; 95%CI 0·3-1·5), and young children (0-5 years; 0·6 hrs/day 95%CI 0·3-0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8-1·3), followed by adults (0·7hr/day 95%CI 0·3-1·2), young children (0·6 hrs/day; 95%CI 0·4-0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3-0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health. INTERPRETATION Pooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area. FUNDING No funding was received for this study.
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Affiliation(s)
- Mike Trott
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, UK
| | - Robin Driscoll
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, UK
| | - Enrico Irlado
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, UK
| | - Shahina Pardhan
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, UK
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Association of Physical Activity and Sedentary Behaviors with the Risk of Refractive Error in Chinese Urban/Rural Boys and Girls. SUSTAINABILITY 2022. [DOI: 10.3390/su14095539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Research shows physical activity (PA) is negatively associated with refractive error, especially outdoor activity. Our study aimed to examine the association of PA levels and sedentary time (SED) with refractive error in boys and girls living in urban and rural areas. Methods: A total of 8506 urban/rural boys and girls (13.5 ± 2.8 years old) in Shaanxi Province, China participated in this study. Questions about PA, SED, outdoor exercises, and digital screen time were asked in the study survey. Non-cycloplegic refractive error was measured by an autorefractor. The differences between sex/area groups have been analyzed by one-way ANOVA. The association of PA/SED with spherical equivalent (SE) and cylinder power was analyzed by general linear regression. The association between PA/SED and the risk of refractive error was determined using the binary logistic regression model. Results: Of the 8506 participants, the prevalence of refractive error was significantly higher in girls and urban students (p < 0.05). Less SED and digital screen time, and more outdoor activity were significantly associated with SE (p < 0.05), respectively. More PA and less SED were significantly associated with lower cylinder power (p < 0.05), respectively. More PA and less SED were significantly associated with lower risks of myopia and astigmatism, respectively (p < 0.05). Conclusions: PA and SED were associated with the risk of refractive error. Maintaining a healthy lifestyle can help to reduce the risk of refractive error in boys and girls.
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Cai T, Zhao L, Kong L, Du X. Complex Interplay Between COVID-19 Lockdown and Myopic Progression. Front Med (Lausanne) 2022; 9:853293. [PMID: 35386915 PMCID: PMC8978626 DOI: 10.3389/fmed.2022.853293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/14/2022] [Indexed: 01/23/2023] Open
Abstract
Purpose To compare the myopic progression before and during strict home confinement when coronavirus disease 2019 (COVID-19) outbreak and explore the potential influencing factors. Methods A cross-sectional study. One hundred and fifteen myopic children (115 right eyes) who replace their frame-glasses from December 2019 to January 2020 and with complete refractive records in our hospital since myopia were involved in the study. At the beginning of the strict home confinement and after a 3-month strict home confinement during the COVID-19 pandemic, they were invited to our hospital to examine the axial length and refractive errors. And visual functions, convergence insufficiency symptom survey (CISS) scale and questionnaires were also performed. Besides, the axial length and refractive errors before the COVID-19 were got from outpatient case files. The effect of strict home confinement on myopia was assessed by comparing monthly axial elongation before COVID-19 and during strict home confinement. Spearman correlation analysis was performed to explore the correlation between potential influencing factors and myopia progression. Results Axial length's monthly elongation during strict home confinement was 35% higher than normal periods (0.046 vs. 0.033 mm/month, P = 0.003). The proportion of severe asthenopia doubled (P = 0.020). For myopia progression, heredity, close indoor work time and electronic products were risk factors. Besides, the protective factors were age, rest time after continuous eye usage, sleep time and distance from eye to computer screen. Conclusions During COVID-19, the decline in outdoor activities and increase of exposure time to digital screens accelerated the progression of myopia by 1/3.
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Affiliation(s)
- Tao Cai
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Lianghui Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Ling Kong
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Xianli Du
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
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21
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Watcharapalakorn A, Poyomtip T, Tawonkasiwattanakun P. Coronavirus disease 2019 outbreak and associated public health measures increase the progression of myopia among children and adolescents: Evidence synthesis. Ophthalmic Physiol Opt 2022; 42:744-752. [PMID: 35315522 PMCID: PMC9115422 DOI: 10.1111/opo.12976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/17/2022]
Abstract
Purpose Although studies have suggested that the coronavirus disease 2019 (COVID‐19) outbreak increased myopia progression, they had different settings and analysis methods. This study compared myopia progression before and during the COVID‐19 outbreak using meta‐analysis. Methods Relevant literature was searched on EMBASE, PubMed, ClinEpiDB and Web of Science and reviewed until 8 October 2021. The Newcastle–Ottawa Scale was used to evaluate the quality of the original studies. The mean difference of change in spherical equivalent refraction (SER) was used for evaluation before and during the COVID‐19 pandemic. Results The meta‐analysis included eight studies with 773, 797 individuals aged 5–18 years. Pooled analysis indicated that the mean difference of annual myopia progression during the pandemic was 0.41 D higher (95% confidence interval [CI]: 0.35–0.48, p < 0.01) than before the pandemic. Subgroup analysis using cycloplegic (mean difference, 0.30 D; 95% CI, 0.22–0.38; p < 0.01) or noncycloplegic refraction (mean difference, 0.60 D; 95% CI, 0.27–0.93; p < 0.01) indicated that the mean difference of annual myopia progression during COVID‐19 significantly increased in both refractive measurements. Conclusion Our findings demonstrated that the COVID‐19 pandemic accelerated myopic progression compared to the past. Government policies are urgently required to prevent and control myopia progression.
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Affiliation(s)
| | - Teera Poyomtip
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
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22
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Yao Y, Fu J, Liu J, Li L, Chen W, Meng Z, Dai W. Distribution, Progression, and Associated Factors of Refractive status of Children in Lhasa, Tibet after COVID-19 Quarantine. Ophthalmic Res 2022; 65:321-327. [PMID: 34856546 PMCID: PMC9059052 DOI: 10.1159/000522548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/07/2022] [Indexed: 11/19/2022]
Abstract
Introduction Uncorrected refractive error is one of the major causes of visual impairment in children and adolescents worldwide. During the COVID-19(Coronavirus Disease 2019) epidemic,home isolation is considered a boost to the progression of children's myopia. Under geographical conditions of high altitude and strong sunshine, the Tibetan plateau is the main residence of the Tibetan population, where little information is available about the refractive status and developmental trajectory.Therefore,this article aimed to evaluate the distribution,progression,and associated factors of the refractive status in second grade children in Lhasa after COVID-19 quarantine. Materials and Methods Students from 7 elementary schools completed comprehensive ocular examinations in the Lhasa Childhood Eye Study. Data regarding cycloplegic refraction and corneal biometry parameters, including axial length (AL),corneal power,anterior chamber depth(ACD),and other demographic factors,were analyzed. Results A total of 1,819 students were included, with a mean age of 7.9±0.5 years, of which 961 were boys (52.8%), and 95.1% were Tibetan. The prevalence of myopia, emmetropia, mild hyperopia and hyperopia was 10.94%, 24.02%, 60.80% and 4.24%, respectively. Besides, the average cycloplegic spherical equivalent refraction(SER) was +1.07±0.92D before the COVID-19 quarantine and +0.59±1.08D after the quarantine, with a growth rate of 7%. Moreover, the prevalence of hyperopia in girls was significantly higher than that of boys. Nonetheless, the proportion of myopia and emmetropia was similar. Meanwhile, children in suburban schools had a significantly lower proportion of myopia. The average AL, ACD, lens power (LP) and axial length-to-corneal radius(AL/CR) ratio were 22.79±0.78mm, 3.54±0.21mm, 25.12±1.48D and 2.93±0.08, respectively. The result of AL,ACD,and AL/CR for girls were significantly lower than for boys while the result of LP is the opposite. Finally, multivariate regression analysis revealed that SER was negatively correlated with AL, LP, and AL-to-CR ratio, while positively correlated with CR and ACD. Conclusion This study found that after the COVID-19 confinement, myopia progressed faster in Lhasa children but was still significantly lower than that of plain cities in China. Compared to short-term confinement, this acceleration was more likely related to the growth and general trend of myopia in children. Collectively, these findings help to explore the differences in ocular growth and development among children of different ethnic groups.
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Affiliation(s)
- Yao Yao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
- *Jing Fu,
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
- *Jing Fu,
| | - Jiawen Liu
- Department of Quantitative Theory and Methods, Emory University, Atlanta, Georgia, USA
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Zhaojun Meng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Wei Dai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
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23
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Ma D, Wei S, Li SM, Yang X, Cao K, Hu J, Peng X, Yan R, Fu J, Grzybowski A, Jin ZB, Wang N. The Impact of Study-at-Home During the COVID-19 Pandemic on Myopia Progression in Chinese Children. Front Public Health 2022; 9:720514. [PMID: 35071149 PMCID: PMC8770940 DOI: 10.3389/fpubh.2021.720514] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To assess the impact of study-at-home during the COVID-19 pandemic on myopia development in Chinese schoolchildren. Methods: This historical cohort involved two groups with a total of 154 children. The exposed group was formed from 77 children aged 8 to 10 years who studied at home in the 7-month period during the COVID-19 pandemic (follow-up period: January - August 2020) and did not study at home in the 7-month period before the COVID-19 outbreak (baseline period: July 2019 - January 2020). Seventy-seven children who did not undergo study-at-home (baseline period: 7 months in 2015, follow-up period: 7 months in 2016) were included in the control group. Cycloplegic refraction, axial length and uncorrected visual acuity were measured 3 times. The questionnaire mainly focused on collecting visual habits. Results: Myopia progression was similar between the two groups in the baseline period. However, in the follow-up period the exposed group had a greater change in refraction toward myopia (-0.83 ± 0.56 D) than the control group (-0.28 ± 0.54 D; p < 0.001). In addition, the exposed group exhibited a significantly greater change in refraction toward myopia in the follow-up period (-0.83 ± 0.56 D) than in the baseline period (-0.33 ± 0.46 D; p < 0.001). Difference-in-difference analysis indicated that study-at-home accelerated the change in refraction toward myopia (t = -0.567; p < 0.001). Conclusions: During the COVID-19 pandemic study-at-home accelerated the change of refraction toward myopia in children.
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Affiliation(s)
- Dandan Ma
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Yang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jianping Hu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Ruohua Yan
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Jing Fu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Andrzej Grzybowski
- University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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24
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Choi KY, Chun RKM, Tang WC, To CH, Lam CSY, Chan HHL. Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2143781. [PMID: 35029662 PMCID: PMC8760616 DOI: 10.1001/jamanetworkopen.2021.43781] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Myopia progression has been found to be worsening during the COVID-19 pandemic. It is important to control the rapid myopia progression in this period. OBJECTIVE To analyze the association of COVID-19-related lockdown measures with myopia progression in schoolchildren and to compare the performance of defocus incorporated multiple segments (DIMS) lens with that of single vision lens (SVL) treatment in reducing myopia progression. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved an exploratory, prespecified, comparison of 2 independent longitudinal studies performed at the same institute beginning in 2019. Data from Hong Kong schoolchildren (aged 7-13 years) were gathered and analyzed. Data analysis was performed from June to July 2021. EXPOSURE Schoolchildren in study 1 wore a DIMS lens for 18 months, and those in study 2 wore a SVL for 24 months. MAIN OUTCOMES AND MEASURES Cycloplegic spherical equivalent refraction and axial length were measured. Studies 1 and 2 started before the start of lockdown measures and continued throughout the lockdown. In both studies, periods of fewer and more COVID-19-related lockdown measures were identified. Because COVID-19 lockdown caused deviations from the visit schedule, myopia progression was normalized to 12-month change, which were compared between DIMS and SVL groups, also during the periods with less and more lockdown time. RESULTS There were 115 participants (58 girls [50.4%]; mean [SD] age, 10.3 [1.5] years) in the DIMS group; their mean (SD) baseline refraction was -4.02 (1.46) D. There were 56 participants (29 girls [51.8%]; mean [SD] age, 10.8 [1.5] years) in the SVL group; their mean (SD) baseline refraction was -2.99 (1.06) D. After controlling for the covariates, DIMS treatment was significantly associated with 34% less axial elongation (0.19 mm [95% CI, 0.16 to 0.22 mm] vs 0.30 mm [95% CI, 0.25 to 0.35 mm]; P < .001) and 46% less myopic progression after 12 months (-0.31 D [95% CI, -0.39 to -0.23 D] vs -0.57 D [95% CI, -0.69 to -0.45 D]; P = .001) compared with SVL treatment. In both the DIMS and SVL groups, more lockdown time was associated with significantly more spherical equivalent refraction (-0.54 D [95% CI, -0.64 to 0.44 D] vs -0.34 D [95% CI, -0.44 to -0.25 D]; P = .01) and axial length (0.29 mm [95% CI, 0.25 to 0.32 mm] vs 0.20 mm [95% CI, 0.16 to 0.24 mm]; P = .001) compared with less lockdown time. No significant interaction between treatment type and lockdown time was observed. CONCLUSIONS AND RELEVANCE In this exploratory analysis, myopia progressed more rapidly in schoolchildren during the period when there were more COVID-19-related lockdown measures. However, optical treatment with DIMS was significantly associated with slower myopia progression compared with SVL treatment during the lockdown period.
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Affiliation(s)
- Kai Yip Choi
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Rachel Ka Man Chun
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Wing Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Carly Siu-yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Henry Ho-lung Chan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
- University Research Facilities in Behavioral and Systems Neurosciences, The Hong Kong Polytechnic University, Hong Kong
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25
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Fan Q, Wang H, Kong W, Zhang W, Li Z, Wang Y. Online Learning-Related Visual Function Impairment During and After the COVID-19 Pandemic. Front Public Health 2021; 9:645971. [PMID: 34912766 PMCID: PMC8666689 DOI: 10.3389/fpubh.2021.645971] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/29/2021] [Indexed: 01/06/2023] Open
Abstract
This study aimed to review the consequences of increased online learning, which was precipitated by the coronavirus disease 2019 (COVID-19), on visual function, as well as the methods for preventing the associated visual impairment. The recent finding implies that a higher incidence of myopia may be observed during the pandemic than that before. The myopia prevalence was 59.35% in COVID-19, which was higher than that in the normal period. COVID-19-related influence of developing myopia among students should be addressed and under control. Online learning precipitated by COVID-19 is likely to increase the global burden of visual function impairment. This review highlighted useful measures to prevent online learning-related visual function impairments, including the following: (1) desktop illumination of no >300 lx, online learning time for primary, and middle-school students of no more than 20–30 min per session; (2) daily video time for preschool children not exceeding 1 h, and for school-age children and adolescents not exceeding 2 h; (3) after every 30–40 min of online learning, moving eyes away from the screen or closed for 10 min; (4) engaging in outdoor activities for ≥ 2 h a day; (5) suitable screen and learning environment settings and correct postures for reading and writing; (6) sufficient sleep and proper nutrition. Preventing online learning-related visual impairment during and after this unprecedented pandemic will facilitate future ophthalmic practice.
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Affiliation(s)
- Qian Fan
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Hongxia Wang
- Shanghai Guanghua Integrated Traditional Chinese and Western Medicine Hospital, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjun Kong
- Beijing You'an Hosptial, Capital Medical University, Beijing, China
| | - Wei Zhang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
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26
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Understanding risks of refractive error among Chinese children amidst pandemic disruptions: results from a rapid survey. BMC Ophthalmol 2021; 21:370. [PMID: 34663261 PMCID: PMC8523284 DOI: 10.1186/s12886-021-02133-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite effectiveness in delaying the spread of the pandemic, frequent and extended disruption to children's livelihoods have fomented new norms in which learning routines encounter immense change. In particular, increased sedentary e-learning engagement with electronic screens and exposure to stressful circumstances are likely to pose adverse risks for children's vision development. METHODS This present study examines the link between near-sighted refractive error, and sedentary exposure to electronic screens, psychosocial stress level, and outdoor activities. A Rapid Survey Methodology (RSM) design was utilized to collect information on subject's vision condition, sedentary electronic screen use, and level of psychosocial stress, in addition to detailed socio-demographic background characteristics. RESULTS This study involves 2234 subjects enrolled in 1st to 6th grade in primary schools. Every 1 diopter hour increase in electronic screen use per day is associated with 1.036 OR (95% CI =1.024-1.047, p-value< 0.050), while every 1 h • W m- 2 sr- 1 of illuminance-weighted electronic screen use per day is associated with 2.285 OR (95% CI =1.829-2.855, p-value< 0.050) increased likelihood of near-sighted refractive error. Higher level of psychosocial stress is associated with 2.441 OR (95% CI =1.870-3.187, p-value< 0.050) and 2.403 OR (95% CI =1.839-3.141, p-value< 0.050) increased likelihood of near-sighted refractive error. Frequency of outdoor activity is not significantly associated with increased likelihood of near-sighted refractive error (p-value> 0.050). CONCLUSIONS Findings in this study show that many factors, including grade level and prior vision condition, contribute to increased risks of near-sighted refractive error during the COVID-19 pandemic. More strikingly, pandemic-related behavioral modifications such as lengthy sedentary electronic screen use and elevated levels of psychosocial stress are two critical channels affecting children's eye health.
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27
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Liu J, Chen Q, Dang J. Examining risk factors related to digital learning and social isolation: Youth visual acuity in COVID-19 pandemic. J Glob Health 2021; 11:05020. [PMID: 34484707 PMCID: PMC8397325 DOI: 10.7189/jogh.11.05020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Around the globe, various self-quarantine, social distancing, and school-closure policies were implemented during the coronavirus disease-19 (COVID-19) outbreak to reduce disease transmission. Many economies/territories were compelled to consider digital learning modalities. In particular, increased digital learning engagement with digital devices and mounting psychosocial stress due to social isolation are likely to pose adverse risks for youth visual health globally. This study examines the association between increased digital device use, psychosocial stress, and myopia symptoms among Chinese youth during the COVID-19 pandemic. Methods This is a retrospective observational population study consisting of 3918 participants enrolled in primary, secondary, and university in China. Participants are recruited through an online survey, which included self-reported information on daily digital device use, psychosocial stress level, condition of visual acuity, and demographic information. We utilize statistical tools including χ2 test, paired sample t test, and multiple multivariate logistic regression. Results Each hour increase in digital device use is associated with 1.25 odds ratio OR (95% confidence interval (CI) = 1.21-1.30; P < 0.001) increased risk of developing myopic symptoms, each additional hour of digital device use weighted by near-view and blue-light exposure is associated with OR = 1.04 OR (95% CI = 1.03-1.05; P < 0.001) and OR = 2.25 (95% CI = 1.94-2.60; P < 0.001) increased risk respectively. Subjects reporting under stressful conditions are between OR = 1.98 (95% CI = 1.67-2.36; P < 0.001) and OR = 2.03 (95% CI = 1.71-2.42; P < 0.001) more likely to develop myopic symptoms, relative to those citing less stress. Conclusions The COVID-19 pandemic led to favorable conditions for myopigenic behavioral changes characterized by extended sedentary engagement with digital devices, which are significantly associated with higher risks of myopia incidence. Relatedly, psychosocial stress accompanying prolonged social isolation during the pandemic is a less noticeable, albeit significant risk factor for myopia development.
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Affiliation(s)
- Ji Liu
- Faculty of Education, Shaanxi Normal University, Xian, Shaanxi, China
| | - Qiaoyi Chen
- School of Basic Medical Sciences, Xian Jiaotong University, Xian, Shaanxi, China
| | - Jingxia Dang
- The First Affiliated Hospital, Xian Jiaotong University, Xian, Shaanxi, China
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